TY - JOUR

AU - Zeidan, Jinan
AU - Fombonne, Eric
AU - Scorah, Julie
AU - Ibrahim, Alaa
AU - Durkin, Maureen S.
AU - Saxena, Shekhar
AU - Yusuf, Afiqah
AU - Shih, Andy
AU - Elsabbagh, Mayada
TI - Global prevalence of autism: A systematic review update
JO - Autism Research
JA - Autism Research
VL - 15
IS - 5
SN - 1939-3792
UR - https://doi.org/10.1002/aur.2696
DO - https://doi.org/10.1002/aur.2696
SP - 778
EP - 790
KW - autism
KW - methodology
KW - prevalence
KW - risk factors
KW - social determinants
KW - time trends
PY - 2022
AB - Abstract Prevalence estimates of autism are essential for informing public
policy, raising awareness, and developing research priorities. Using a systematic
review, we synthesized estimates of the prevalence of autism worldwide. We examined
factors accounting for variability in estimates and critically reviewed evidence
relevant for hypotheses about biological or social determinants (viz., biological
sex, sociodemographic status, ethnicity/race, and nativity) potentially modifying
prevalence estimates of autism. We performed the search in November 2021 within
Medline for studies estimating autism prevalence, published since our last
systematic review in 2012. Data were extracted by two independent researchers.
Since 2012, 99 estimates from 71 studies were published indicating a global autism
prevalence that ranges within and across regions, with a median prevalence of
100/10,000 (range: 1.09/10,000 to 436.0/10,000). The median male-to-female ratio
was 4.2. The median percentage of autism cases with co-occurring intellectual
disability was 33.0%. Estimates varied, likely reflecting complex and dynamic
interactions between patterns of community awareness, service capacity, help
seeking, and sociodemographic factors. A limitation of this review is that
synthesizing methodological features precludes a quality appraisal of studies. Our
findings reveal an increase in measured autism prevalence globally, reflecting the
combined effects of multiple factors including the increase in community awareness
and public health response globally, progress in case identification and
definition, and an increase in community capacity. Hypotheses linking factors that
increase the likelihood of developing autism with variations in prevalence will
require research with large, representative samples and comparable autism
diagnostic criteria and case-finding methods in diverse world regions over time.
Lay Summary We reviewed studies of the prevalence of autism worldwide, considering
the impact of geographic, ethnic, and socioeconomic factors on prevalence
estimates. Approximately 1/100 children are diagnosed with autism spectrum disorder
around the world. Prevalence estimates increased over time and varied greatly
within and across sociodemographic groups. These findings reflect changes in the
definition of autism and differences in the methodology and contexts of prevalence
studies.
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